Published by the Public Accounts Committee (PAC) this evening, the memo shows that Mr O'Brien was aware of the CervicalCheck audit two years ago.

The document informs the health service that the National Screening Service would soon begin informing patients about the results of an audit it conducted in 2014 into over 1,200 cancer screening cases.

It said that 86 letters had been sent to doctors treating women who had been included in the audit and had since been diagnosed with cancer.

It said a further 200 would be sent in the following months.

The memo also reveals that the national screening programme was preparing for media fallout over misdiagnoses in 2016

In the earliest version of the memo, the authors wrote: "There is always the risk that in communicating individual case reports to clinicians of an individual patient reacting by contacting the media if they feel that ‘screening did not diagnose my cancer.’

"This is a risk that is inherent in having a clinical audit process as part of the national programme."

That version also included suggested next steps - advising recipients to pause all letters, await solicitors' advice, and to "continue to prepare reactive communications response for a media headline that 'screening did not diagnose my cancer'."

In his appearance before the committee earlier today Mr O'Brien said the memo did not "ring alarm bells" because the women involved were set to be informed.

He told TDs that he had been "advised that the audit had not thrown by any issues of concern."

"I was advised that the audit would be communicated to the individuals who were the subject of that audit," he said.

"I was provided with quite some detail as to how it would be done... I was never subsequently told that any issues had arisen, or anything had happened to disrupt that plan."

Vicky Phelan

The cervical scandal was brought to light after terminally ill mother Vicky Phelan settle a case with the HSE.

It emerged in the days after the settlement that after the audit revealed that there may be a problem with test results relating to 208 women - however only 36 were informed.

It meant that some 162 were not contacted.

According to the latest HSE statement on the scandal, released yesterday, the audit revealed 209 women whose screening test 'could have provided a different result.'

The executive said it is still working to contact all the women affected - and has now been in touch with 201 women or families.

A special cabinet meeting due to be held in Monaghan tomorrow has been moved back to Dublin so the Taoiseach can continue to deal with the scandal.

Health Minister Simon Harris and Taoiseach Leo Varadkar have decided to stay in Dublin to work on the issue.

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